WASH Benefits Child Development Follow up
- Conditions
- Child DevelopmentMaternal Depression
- Interventions
- Behavioral: Water qualityBehavioral: SanitationBehavioral: Hand washingBehavioral: Water quality, Sanitation, Hand washing (Combined WASH)Behavioral: NutritionBehavioral: Nutrition, Water quality, Sanitation, Hand washing
- Registration Number
- NCT04443855
- Brief Summary
The purpose of this study is to determine if the effects of individual and combined water, sanitation, hygiene, and nutrition interventions in early childhood on child development and maternal mental health persist into middle childhood. This study is a follow-up assessment of the children and mothers enrolled in the WASH-Benefits Bangladesh study.
- Detailed Description
Globally, millions of children experience delays in physical health and cognitive development, due to their exposures to poverty and related issues. In low-and middle-income countries, children experience a dis-proportionally high burden of exposure to poverty and related risk factors for delayed development including of poor health and nutrition, inadequate responsive care giving, and a lack of opportunities for early learning. Water, sanitation and hygiene (WASH) interventions have the potential to positively affect the developmental trajectories of children by reducing enteric pathogen infection, improving child health, and altering parental care practices. A recent cluster-randomized controlled trial (cRCT) in Bangladesh (WASH-Benefits, or WASH-B, Clinical Trials.gov Identifier: NCT01590095), found that improvements in WASH or nutrition supported by intensive interpersonal communication, when delivered either individually or in combination, contributed to improvements in child development outcomes at 1 and 2 years of age, and mothers in all intervention groups reported lower depressive symptoms than mothers in the control households.
This follow-up study, funded by the Bill \& Melinda Gates foundation, includes assessments of the children and caregivers originally enrolled in the WASH Benefits intervention 5 years following intervention completion, when the children are 5-8 year of age. The original WASH Benefits intervention enrolled pregnant women between May 31, 2012, and July 7, 2013. The goal of this follow-up study is to examine whether the improvements in child development and maternal mental health are sustained when the children are in middle childhood. Our guiding hypothesis is that interventions that showed early impact will continue to improve child and maternal outcomes at this follow-up time period. Investigators will attempt to collect follow-up data from every household originally randomized to one of the 7 arms in the WASH Benefits trial.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 4932
- Enrolled in the wash-benefits Bangladesh intervention
- No Exclusion criteria
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Water quality Water quality 90 clusters, approx. 720 newborns Sanitation Sanitation 90 clusters, approx. 720 newborns Hand washing Hand washing 90 clusters, approx. 720 newborns Combined WASH Water quality, Sanitation, Hand washing (Combined WASH) 90 clusters, approx. 720 newborns Nutrition Nutrition 90 clusters, approx. 720 newborns Nutrition+ Combined WASH Nutrition, Water quality, Sanitation, Hand washing 90 clusters, approx. 720 newborns
- Primary Outcome Measures
Name Time Method Weschler Primary and Preschool Scales of Development 4th edition (WPPSI-IV) 5 years after intervention completion The WPPSI-IV assessment measures cognitive development and general intellectual abilities in children 2 years 6 months to 7 years 7 months of age (2:6-7:7), and includes assessments of both performance and verbal skills.
Executive Functioning 5 years after intervention completion This executive functioning assessment consists of three sub-scales to assess executive functioning in children including verbal memory, visual and non-verbal memory, and memory capacity.
Child Socioemotional Development 5 years after intervention completion Maternal-report questionnaire designed to measure psychological adjustment in children and aims to detect any emotional or behavioural problems.
Fine Motor Development 5 years after intervention completion Manual Dexterity component of Movement Assessment Battery for Children-2 (MABC-2) is a direct assessment tool used to measure fine motor skills in children 3 to 17 years of age.
Academic achievement 5 years after intervention completion The Wide Range Assessment Test (WRAT) assessment is a written and verbal assessment of reading, writing, and math achievement.
- Secondary Outcome Measures
Name Time Method Maternal Mental Health 5 years after intervention completion Center for Epidemiologic Studies Depression Scale (20 questions). This scale contains 20 questions asking about the number of days in the past week the respondent has experienced each of the symptoms.
Home environment 5 years after intervention completion The middle childhood HOME includes caregiver report and observational items to assess the quality and quantity of stimulation and support available to the child at home.
School attendance 5 years after intervention completion Parental report
Height-for-Age Z-scores 5 years after intervention completion Child's standing height, standardized to Z-scores using the WHO 2006 growth standards
Weight-for-Height Z-scores 5 years after intervention completion Child's weight and height, standardized to Weight-for-Height Z-scores using the WHO 2006 growth standards
Trial Locations
- Locations (1)
International Centre for Diarrhoeal Disease Research, Bangladesh
🇧🇩Dhaka, Bangladesh